What to feed someone being and feeling sick all the time

Hi, In spite of taking cyclizine and now metoclopomine for sickness, Steve has been sick twice today, and once at bed time last night. He started his chemo Gem/Cap yesterday, but this has been increasingly more sick over the last week. He managed breakfast (with Creon), then had a coffee and chocolate biscuit mid morning. Then was sick at 12 and hasn't wanted to eat since. He's just been sick again - bile now as there's nothing in his stomach. What do you do in this situation? He needs to eat as he's skin and bones, and has to have something in his stomach for the Cap tablets this evening. Our MacMillan nurse is coming to introduce herself to us tomorrow, but in the meantime, what do I do for him? He takes paracetamol and is on Fentanyl patches and Oramorph for the pain.

Sorry for bombarding the forum with questions, but it's all very new and scary.

Thanks, Diane x

Hi Diane

Hopefully by now you will have all the clinical information from the Macmillan nurse but if not do contact Jeni, the PCUK support nurse. Her details are at the top of every forum.

Kind regards

Nicki

Hi,

We have now been prescribed domperidone for the sickness and Steve is on 2 tablets twice a day. He is still being sick, but more like once a day now, usually about an hour or two after food, and always (sorry) lots of phlegm in it. We have had a very shakey week though. Last Saturday, Steve started on Dexamethasone 2mg three tablets in the morning to try and improve his appetite and the nausea. On Sunday morning Steve woke up all itchy. As we weren't sure if this was from the Steroids or chemo, I phoned our chemo nurse on Monday morning for advice. She suggested our GP gave Steve the once over. He checked Steve's blood sugar levels and they were at 21. So on advice, he ended up in hospital overnight for monitoring. The upshot is that he's diabetic, on top of everything else! So he now has to take half a Gliclazide tablet daily (ie 40mg) and monitor his sugar levels throughout the day. He had his Gem chemo on Wednesday as normal, and they are pleased that he doesn't seem to be getting any side effects of the chemo. The nausea was there prior to chemo, and was getting to be twice a day but hasn't increased on the chemo. They are thinking there may be a blockage in his gut which they want to investigate with a barium x-ray.

Do any of your other halves (it does appear to be the other halves that are on this forum), suffer with cold hands and feet? On Thursday Steve went to make a cuppa mid morning and came over all dizzy and started to shake uncontrollably and his temperature dropped to 33.6. It took over an hour and lots of blankets, jumpers to warm him up, but since then his temperature hovers on the low side. His fingers are white, and it is really difficult to do the pin prick for his blood sugars. The GP came out to check on Steve and said there was nothing obvious.

The good news is that Steve is no longer in pain - 37mg Fentanyl patches are doing the trick - no more paracetamol top ups or oramorph needed. We just have to sort out the nausea/vomiting.

hi there,, my husband is also on domperidone and takes 2 tabs 4x daily we changed from metacloropdine? as he had a lot of problems with really deep unpleasant belches, domp helps better with that, now on 15th month cycle of gemcap, he lost 4stone just prior to diagnosis when he was jaundiced it also started him being diabetic, tabs and insulin, all cleared up now for bout 7 or 8 mths!, food still sometimes a problem, not fancying, or not liking it even though he asked for it, if all else fails he will have an ensure he quite enjoys the fruit flavoured ones and one is a complete meal, at one point he was on a "diet" of cheese n biscuits n pickle and trifle? but hey as long as he eats i go along with it, also we use 8 plus creon a day, cant od on them and really seem to help with digesting the food, cause if you dont have something like that the food wont be doing much good.

hope this may be of some help.. best wishes to you both, and all on here, laura

Hi Laura, Thanks for your reply. I'm glad to hear that your husband is in his 15th month of GemCap. Is he on the SCALOP trial or just being provided with both chemotherapies. Our Macmillan equivalent nurse came round today and suggested Steve take 1 Domp at night instead of 2 as he has trouble sleeping. It may of course be the Steroids, but we are decreasing them to one tablet tomorrow. He has had a good day today - I shall note it in my 5-year diary (have been keeping them since my teens), managed to keep all food down, sit in the garden, managed a good walk and not needed a doze at all. It could be the Steroids are perking him up at last. He too has lost a lot of weight. He started at 70 Kgs and is now 45 1/2 Kgs. He isn't allowed to lose more that 10% of body weight or he'll be taken off the trial so it is a battle to keep him grazing throughout the day. He has discovered chocolate and vanilla petit filous which he helps himself to from the fridge. He quite likes the chocolate and vanilla Fortisips so some days they replace a meal. I constantly have to remind him about the Creon. As far as the chemo is concerned, the only side effect we can think of is that his body temperature has dropped by a degree or so to 35ish and his hands and feet are permenantly freezing - a bit of a problem when he has to do the finger pricks for blood sugars. Hoping for another good day tomorrow - and I wish the same for you and your husband too. Diane xx

Hi Diane,

Good news to hear that Steve has perked up a bit. Indeed, it could be a feature of the steroids, as that is one of the effects they have. Unfortunately, they will also push up the blood sugar levels, so maybe that is the cause of the diabetes? It could also have been that it was what pushed the glucose levels up, where there was an underlying propensity to diabetes because of the cancer. Steroids also definitely cause wakefulness, so make sure he does not take them too late in the day.

Creon should be taken with every morsel eaten -even a milky drink. And, before eating. This is how they work best. Some of the weight loss maybe because he is under-dosing on the creon. This is more often the case with pancreatic cancer sufferers. To get the best out of the food he is eating, the amount of creon may need to be increased. Do you know what dose he is on? (this will be written on the box the capsules come in) He should also take them with the supplements. Is it possible that he might have the fortisips AS WELL as his meals, or is this too much for him? You mentioned that he takes them to replace a meal - he can actually take them as well as meals. The more calories he takes in, the more likely he is to gain weight.

If you need more details, please email me at the support address on the top of the forums.

Jeni.